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SANTIAM MOBILE MEDICINE LLC
NPI 1750899035
Nurse Practitioner in Stayton, OR

Active since January 20, 2018CLIA 38D2146974 · Waiver
41805 STAYTON SCIO RD SE, STAYTON, OR 97383(503) 507-5356(866) 225-2708 Get Directions Write a Review

NPPES record last updated: May 31, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 31, 2025, Jan 27, 2021, Jul 1, 2020 and 3 more (6 updates tracked since 2018).

About Santiam Mobile Medicine Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANTIAM MOBILE MEDICINE LLC (NPI 1750899035) is a healthcare organization registered as a nurse practitioner in Stayton, Oregon and active in the NPI registry since January 2018. The organization holds a CLIA Waiver certificate valid through April 9, 2028 and lists Casey Lulay, Member, as its authorized official.

NPPES Registry Identity

NPI1750899035
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameSANTIAM MOBILE MEDICINE LLC
Location Address41805 STAYTON SCIO RD SEStayton, OR 97383-9739
Mailing AddressPo Box 118Stayton, OR 97383-0118 · (503) 507-5356 · Fax (866) 225-1708
Phone(503) 507-5356
Fax(866) 225-2708
Organization SubpartNo
Authorized OfficialCasey LulayMember · (503) 507-5356
Enumeration DateJanuary 20, 2018
Last NPPES UpdateMay 31, 20256 updates tracked since enumeration
NPPES CertifiedMay 31, 2025
✔ NPI 1750899035 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
41805 STAYTON SCIO RD SE, Stayton, OR 97383
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Other Identifiers 2

Medicaid500673258OR
Medicaid500779652OR

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D2146974

Santiam Mobile Medicine · Stayton, OR
Active · expires Apr 9, 2028
CLIA Number38D2146974
Laboratory TypeMobile Laboratory
Certificate Effective DateApril 10, 2026
Certificate Expiration DateApril 9, 2028
Laboratory DirectorCasey Lulay
Laboratory Phone(503) 507-5356
Laboratory LocationSantiam Mobile Medicine41805 Stayton Scio Rd SE, Stayton, OR 97383
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAIGE PATTILLO NP
Nurse Practitioner (Family)
41805 STAYTON SCIO RD SE
STAYTON, OR 97383
Marion County (503) 507-5356
MRS. LUANNA LEE DISHON MSN, APRN, FNP-C
Nurse Practitioner (Family)
41805 STAYTON SCIO RD SE
STAYTON, OR 97383
Marion County (503) 507-5356
AMARA MCGEE
Nurse Practitioner (Family)
41805 STAYTON SCIO RD SE
STAYTON, OR 97383
Marion County (503) 507-5356
CASEY LULAY FNP-C
Nurse Practitioner
41805 STAYTON SCIO RD SE
STAYTON, OR 97383
Marion County (503) 507-5356
MRS. JILL COHEN
Nurse Practitioner (Family)
41805 STAYTON SCIO RD SE
STAYTON, OR 97383
Marion County (503) 507-5356

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Santiam Mobile Medicine LLC's NPI number?

The NPI number for Santiam Mobile Medicine LLC is 1750899035. It was assigned to this organization in the NPPES registry on January 20, 2018.

Where is Santiam Mobile Medicine LLC located?

Santiam Mobile Medicine LLC is located at 41805 Stayton Scio Rd SE, Stayton, OR 97383. The listed phone number is (503) 507-5356.

What is Santiam Mobile Medicine LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Santiam Mobile Medicine LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2146974) is associated with this NPI, valid through April 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Santiam Mobile Medicine LLC accept?

Health plans from Moda Health Plan, Inc. and Providence Health Plan list Santiam Mobile Medicine LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Santiam Mobile Medicine LLC was last updated on May 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.